Provider Demographics
NPI:1760497333
Name:MAUMEE INTERNISTS, INC.
Entity Type:Organization
Organization Name:MAUMEE INTERNISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHWISOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-893-3306
Mailing Address - Street 1:7550 LUCERNE DR
Mailing Address - Street 2:SUITE 405
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-6588
Mailing Address - Country:US
Mailing Address - Phone:419-893-3306
Mailing Address - Fax:419-893-2274
Practice Address - Street 1:5600 MONCLOVA RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1800
Practice Address - Country:US
Practice Address - Phone:419-893-3306
Practice Address - Fax:419-893-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0371048Medicaid
OHMA9913862Medicare PIN